Point paper for national centers for accident prevention and control, Board of Scientific Counselors - December 2019 meeting

Point papers are a long-standing tradition in military and government policy making circles. Unlike most medical journal papers, they are formatted with a minimum of verbiage to summarize an issue for decision making. The authors write in that tradition, adding references for key points. We speak on behalf of millions of people in pain and their healthcare providers, who have been predictably and unnecessarily harmed by the 2016 CDC Guidelines on prescription of opioids to adults with chronic non-cancer pain. Guidelines were not only "misapplied" but factually in error on multiple issues : Sweeping conclusions were drawn from very weak data or unsupported opinion. Rarity of long term trials was falsely conflated to insinuate that opioids are ineffective in the long term. Well known genetic factors in opioid metabolism were ignored; these factors invalidate generalization of dose thresholds in effectiveness or risk. Real risk of addiction or mortality from prescription opioids was grossly over-magnified and hyped. Patient addiction from medical exposure is in fact rare. Over prescribing of opioid pain relievers by physicians to their patients did not create America's public health crisis -- and data published by CDC prove it beyond contradiction.

Author(s): Richard A Lawhern

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